Quadratus Lumborum

Original Editor - Vanessa Rhule

Top Contributors - Vanessa Rhule, George Prudden, Wendy Walker and Naomi O'Reilly

Description

The word quadratus comes from the Latin word "quadrus" meaning “square” while Lumborum comes from the Latin word "lumbus" for “loin.”

A thick, irregular, quadrilateral-shaped muscle sheet that lies in the posterior abdominal wall.

Anatomy

Origin[1]

Posterior Iliac Crest

Insertion[1]

Medial half of 12th rib and transverse processes of lumbar vertebrae


Quadratus-lumborum-muscle-fibers.jpg

Nerve Supply[1]

Subcostal nerve (T12)
Iliohypogastric and Ilioinguinal nerve (both from L1)
Branches from the ventral rami (L2 and L3)

Blood Supply[2]

Branches of the subcostal artery
Branches of the lumbar arteries
The lumbar branch of the iliolumbar artery
The arteria lumbalis ima from the median sacral artery.

Function

Actions[2]

Quadratus Lumborum fixes the12th rib to stabilise diaphragm attachments during inspiration

Lateral flexes the vertebral column

Extends lumbar vertebrae

Functional contributions

The primary antagonist to each Quadratus Lumborum muscle is the Quadratus Lumborum muscle on the other side of the body.[3]

The muscle group is considered a postural muscle group.

Trigger Point Referral Pattern

Quadratus lumborum trigger points referred pain-1024x768.jpg

Quadratus-lumborum-trigger-point-interactions.jpg


Techniques

Palpation

Related Pathologies

Dysfunction of the Lumbar structures whether degenerative, neuropathy, and/or inflammatory, may contribute to poor muscle firing and weak stabilization by the QL. [4]

Lumbar spine pathologies like bulging discs, and facet joint hypertrophy from chronic inflammation may effect nerve conduction and response to the QL and Iliopsoas resulting in poor muscle stabilization and mechanical stress from chronic contracture. [4]

Moaratty-Koehler Syndrome (MKS) is another condition related to QL dysfunction

Treatment

Resources

References

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  1. 1.0 1.1 1.2 Anatomyexpert.com. AnatomyEXPERT: Quadratus lumborum - Structure Detail [Internet]. 2015 [cited 15 August 2015]. Available from: http://www.anatomyexpert.com/app/structure/5307/
  2. 2.0 2.1 Jarvis M. Quadratus lumborum | Radiology Reference Article | Radiopaedia.org [Internet]. Radiopaedia.org. 2015 [cited 15 August 2015]. Available from: http://radiopaedia.org/articles/quadratus-lumborum
  3. Perry D. Quadratus Lumborum Trigger Points: Masters of Low Back Pain | TriggerPointTherapist.com [Internet]. Triggerpointtherapist.com. 2011 [cited 15 August 2015]. Available from: http://www.triggerpointtherapist.com/blog/quadratus-lumborum-trigger-points/ql-trigger-points-masters-low-back-pain/
  4. 4.0 4.1 Reller P. Low Back and Lower Body Myofascial Pain Syndromes | Acupuncture Integrated [Internet]. Acupunctureintegrated.com. 2015 [cited 22 August 2015]. Available from: http://www.acupunctureintegrated.com/articles/low-back-and-lower-body-myofascial-pain-syndromes